Gail Torres remembers stashing the Pocket Guide to Nutrition Assessment of Patients With Kidney Disease—which weighed about a pound—in her lab coat when she treated patients. Working as a nurse and nutritionist, carrying around books and notes would leave her neck and shoulders hurting by the end of the day. Partly for that reason, Torres, who is senior clinical communications director in the Kidney Learning System at the National Kidney Foundation (NKF), educates physicians on a less strenuous way to have health care information readily available to them: apps.
If physicians are not using apps in their daily routine, they probably should be. There are at least 1 or 2 apps that can be used for education and/or patient care. “You don’t lose anything by using them, but you may gain a lot,” Torres said. “They are worth your time to check them out.”
For patients
Ronald Yap, the director of the men’s urologic health program at Concord Hospital in Concord, New Hampshire, created the app Bladder Pal and Prostate Pal. Physicians and patients can use the apps. Patients can track such details as incontinence pad changes and fluid intake and urine output. Not only can patients record symptoms, but they can export the information to an Excel spreadsheet, which allows them to send the information to their physician.
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“I’ve had patients come in with voiding diaries on rolled up pieces of paper or scraggy wired notebooks,” Yap said. “Instead of having patients fill out paperwork, it [the app] can expedite visits… [and] save time, energy and effort,” Yap said.
Torres recommends MyMedSchedule, especially for older patients. It provides reminders for taking and refilling medications, and allows patients to print out their medication schedules to take to a provider.
“Apps make life a lot easier, and for patients it’s a good way to self-empower them,” she said. “When they track their own information it gives them a good sense of control.
Apps can also avoid the tedium of tracking statistics. Patients may find it boring to write down what they eat, but tracking dietary intake via an app can be fun. If they are tracking food, specific health apps, like NKF’s My Food Coach, can provide specific parameters and recipes for a kidney-healthy diet.
Benefits for the practice
Apps do not need to be confined to patient use either. One of the apps most frequently downloaded from the NKF is the glomerular filtration rate (GFR) calculator. There are a host of “calculator” apps that provide information such as body mass index or intravenous solutions that physicians can incorporate into their practice. Having these apps in a smartphone is more convenient than relying on the availability of a computer, Torres said.
Some apps have patient education materials that can be printed out. Physicians can sit by a patient’s bedside and show them the information. Sometimes you can graph their information on a chart to show them health trends.
Physicians can use apps to keep up with their education and industry changes. The American Urological Association’s Guidelines at a Glance app offers practice guidelines and best practice information. Yap said this is the easiest way to keep up with changes as they are made by the AUA. He also recommends the app from the National Comprehensive Cancer Network, NCCN Guidelines for Smartphones. This app provides the organizations’ recommendations for management and interventions of most malignant cancers as well as prevention and screening information. The guidelines are compiled from experts at major cancer hospitals and are updated regularly.
Special considerations
Most older adults have smartphones, and many apps are simple and easier to use than a computer for tracking and entering information. For patients who do not have a smartphone or cannot see well enough to use an app, it may be helpful for a caregiver or family member to keep information for them in the app.
Torres advises physicians to use evidence-based apps, based on national guidelines from trustworthy sources. Such sources include the NKF, American Society of Nephrology, AUA, the National Institutes of Health, and the Centers for Disease Control and Prevention.
Physicians should vet apps they recommend to patients. Some apps are sponsored by drug companies and may present information in a biased way toward their product. Those that use guidelines should be up to date. For apps that recommend vitamins or supplements, physicians should make sure the information has been reviewed by an independent party.
Yap recommends avoiding apps that have a high fee or require in-app purchases. Sometimes they are free to begin with and then require payment after a few uses. Some are littered with ads.
“If you recommend something, patients will take it as the God’s honest truth,” Yap said. “You want to use it, check it out and make sure it is going to be useful to you and your patients.”
